Genotype-directed Neoadjuvant Chemoradiation for Rectal Carcinoma

NCT ID: NCT00682786

Last Updated: 2017-10-06

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

135 participants

Study Classification

INTERVENTIONAL

Study Start Date

2002-10-31

Study Completion Date

2010-08-31

Brief Summary

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Determine if genotype-directed neoadjuvant chemoradiation, using information from the thymidylate synthase promoter polymorphism, result in a greater degree of tumor downstaging in high risk patients compared to historical controls.

Detailed Description

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Conditions

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Rectal Carcinoma

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Good Risk (Thymidylate Synthase (TYMS)*2/*2, *2/*3, *2/*4)

Radiation 45 Gy in 25 fractions to the pelvis.

5FU CIVI 225 mg/m2/day by CIVI during radiation

Surgery 6-10 weeks after completion of preoperative radiation if disease has become resectable.

Group Type EXPERIMENTAL

5FU

Intervention Type DRUG

Radiation

Intervention Type RADIATION

Surgery of resectable lesions

Intervention Type PROCEDURE

Poor Risk (Thymidylate Synthase (TYMS)*3/*3, *3/*4)

Radiation 45 Gy in 25 fractions to the pelvis.

5FU CIVI 225 mg/m2/day by CIVI during radiation

Irinotecan 50 mg/m2 IV weekly for 5 doses.

Surgery 6-10 weeks after completion of preoperative radiation if disease has become resectable.

Group Type EXPERIMENTAL

5FU

Intervention Type DRUG

Radiation

Intervention Type RADIATION

Surgery of resectable lesions

Intervention Type PROCEDURE

Irinotecan

Intervention Type DRUG

Interventions

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5FU

Intervention Type DRUG

Radiation

Intervention Type RADIATION

Surgery of resectable lesions

Intervention Type PROCEDURE

Irinotecan

Intervention Type DRUG

Other Intervention Names

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Fluorouracil 5-fluorouracil Camptosar

Eligibility Criteria

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Inclusion Criteria

* Biopsy proven adenocarcinoma of the rectum
* Lesion evaluated by surgeon and found to be resectable
* Stage T3 or T4 disease on radiography or ultrasound
* Karnofsky Performance Status at \>60
* Laboratory criteria:

* Absolute neutrophil count \>= 1.5 K
* Platelets \>= 100 K
* Total Bilirubin \<= 2.0;
* SGOT and Alkaline Phosphatase \<= 2 x upper limit of normal
* Creatinine \< 2.0
* Informed consent signed
* Patients with distant metastatic disease will be eligible if they satisfy all other conditions.

Exclusion Criteria

* Pregnant women, children \< 18 years, or patients unable to give informed consent
* Patients with a past history of pelvic radiotherapy.
* Patients with prior malignancy in the past 5 years except: skin cancer or in-situ cervical cancer. However, patients with synchronous adenocarcinomas are eligible provided either (a) the synchronous adenocarcinoma was in a removed pedunculated polyp and did not invade the stalk or (b) the synchronous adenocarcinoma was in a removed polyp that lay within the surgical field (extent of resection would not be changed) or (c) the synchronous adenocarcinoma is smaller than the index rectal cancer and lies completely within the radiation field (clinically favorable second lesion and the extend of radiation and surgery would not be changed).
* Patients with known allergy to 5-fluorouracil or irinotecan
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Washington University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Benjamin Tan, M.D.

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Locations

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Washington University School of Medicine

St Louis, Missouri, United States

Site Status

Countries

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United States

Related Links

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http://www.siteman.wustl.edu

Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine

Other Identifiers

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02-0561

Identifier Type: -

Identifier Source: org_study_id